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Underwritten by WHOLESALE CORPORATION Unum Life Insurance Co of America LTC Department 2211 Congress Street Portland Maine 04122 Your Name Last Name First Middle Initial EMPLOYEE SPOUSE OR DOMESTIC PARTNER Group 5 Benefit Election Form Long Term Care Policy 543523-002 Social Security Number - - Gender Male Female Home Telephone Street Address City State Zip Code Complete the following only if applicant is not the employee Employee s Name Employee Social Security No. Date of Birth MM/DD/YYYY / / Date of Hire MM/DD/YYYY Work Telephone Employee Date of Birth Applicant Is This Benefit Election Form must be completed for any selection Employee Employee s Spouse Employee s Domestic Partner You may choose any of the plans listed below. The Long Term Care Application medical questionnaire the Benefit Election form and a signed Authorization to Request Medical Information Form 6720-03 located in the enrollment kit must be completed and you must be approved for coverage in order to enroll in th....

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Maine has a graduated individual income tax, with rates ranging from 5.80 percent to 7.15 percent. Maine also has a corporate income tax that ranges from 3.50 percent to 8.93 percent. Maine has a 5.50 percent state sales tax rate and does not levy any local sales taxes.

Anyone who is a resident of Maine for any part of the tax year, and has taxable Maine-source income, must file a Maine return. Anyone who is not a resident of Maine, but performs personal services in Maine for more than 12 days and earns more than $3,000 of income from all Maine sources, must file a Maine return.

Maine Tax Rates, Collections, and Burdens Maine also has a corporate income tax that ranges from 3.50 percent to 8.93 percent. Maine has a 5.50 percent state sales tax rate and does not levy any local sales taxes. Maine's tax system ranks 35rd overall on our 2023 State Business Tax Climate Index.

If you make $100,000 a year living in the region of Maine, USA, you will be taxed $28,546. That means that your net pay will be $71,454 per year, or $5,955 per month. Your average tax rate is 28.6% and your marginal tax rate is 39.4%.

Maine state tax forms are available for download via the link below; order online using the Maine Revenue Services Electronic Request Form; call the forms line at 207-624-7894 (leave your name and mailing address); or write to Maine Revenue Services, P.O. Box 9107, Augusta, ME 04332-9107.

Anyone who is a resident of Maine for any part of the tax year, and has taxable Maine-source income, must file a Maine return. Anyone who is not a resident of Maine, but performs personal services in Maine for more than 12 days and earns more than $3,000 of income from all Maine sources, must file a Maine return.

Form 1310ME is used to claim an income tax refund on behalf of a taxpayer who has died. The form must be completed by the person who is claiming the refund.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232